Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Pain Management in Non-surgical Inpatients - Treatment Approaches and Competence for Pain Services].
The number of non-surgical patients in the hospital setting with pain due to medical conditions or comorbidities and/or invasive procedures or treatments is high. Compared to perioperative pain management, the portion of patients and/or conditions that require more than an approach focused on pharmacological treatment of nociceptive pain is considerably higher. Rather, treatment often requires the differentiated use of co-analgesics, non-pharmacological treatments, physiotherapy, occupational therapy, psychological assessment and interventsions and educational approaches, ideally in the form of closely coordinated interdisciplinary treatment. The assessment and treatment of acute and especially chronic pain should follow the biopsychosocial concept of pain, especially if risk factors for chronification have been identified, if patients receive high-dose therapy with analgesics or have preexisting a chronic pain disorder.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Procedure Specific Pain Therapy - the PROSPECT Idea].
Acute pain therapy following operative or interventional procedures has become a compulsory component of a modern perioperative patient management. A structured pain regimen has several clear advantages: it leads to an improvement of the patients' quality of life in the short term, it reduces perioperative morbidity in the medium term, it reduces pain chronification in the long term, at the same time improving the economic efficiency due to an accelerated mobilization, a reduction of the hospitalization and an avoidance of complication inherent costs. This article provides detailed information on the change of paradigm, away from a generalized and rather unspecific acute pain therapy towards a problem oriented procedure specific regimen. It points out two examples of the PROSPECT (PROcedure SPECific pain managemenT) methodology and explains its background.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Post-polio Syndrome in the Perioperative Phase].
Due to the numerous poliomyelitis epidemics that have continued over the last decades and the post-polio syndrome (PPS) that occurs 10 - 30 years after poliomyelitis infection, the prevalence of PPS is also expected to increase in Europe. At the same time, due to the musculoskeletal disorders associated with the underlying disease, PPS patients often require surgery for which special anaesthetic requirements must be taken into account. In this analysis we summarise the current evidence and recommendations.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Perioperative Pain Management - Patient Information, Informed Consent and Discharge Management].
Many surgical procedures are followed by postoperative pain. Acute pain should be treated optimally for medical and ethical reasons. Different psychological, physical, interventional and pharmacological methods are employed in a procedure specific and institution specific matter. ⋯ To address these issues adjustments in informed consent and patient information and education are necessary. This includes also the information and education of caregivers. This article describes the legal framework, technical solutions and the impact of placebo and nocebo effects on doctor-patient communication.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Anesthesia Technical Assistants - a New Job Description in Health Care].
For many colleagues, the job of anesthesia technical assistant (ATA) is a new - previously unknown - job description in the healthcare sector. The anesthesia departments currently employ qualified nurses (3 years of training) or specialist nurses (5 years of training). However, there has been a known shortage of skilled workers in the care industry for many years. ⋯ At the same time, this new field of work was supposed to be attractive and to train specialists - directly. In the future, the anesthesia departments will be supported by anesthesia technical assistants. This article explains the training structure and areas of responsibility.